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目的探讨经皮椎体后凸成形术(PKP)结合过伸体位复位治疗骨质疏松性椎体压缩骨折不愈合的临床疗效。方法回顾性分析自2010-03—2012-03采用PKP结合过伸体位复位治疗骨质疏松性椎体压缩骨折不愈合10例,通过测量手术前后椎体前缘高度、椎体前后缘高度比值(Beck值)、Cobb角及疼痛视觉模拟评分(VAS)的变化来评估临床疗效。结果本组手术时间20~40 min,单个椎体骨水泥注入量4.5~10 ml,平均6.5 ml。10例均获得随访6~24个月,平均12.6个月。术后与末次随访的伤椎前缘高度、Cobb角、Beck值、VAS评分较术前明显改善,差异有统计学意义(P<0.05);且末次随访时各项指标维持良好,与术后比较差异无统计学意义(P>0.05)。结论骨质疏松性椎体压缩骨折不愈合具有典型的临床及影像学特点,采用PKP治疗效果满意,结合过伸位体位及手法复位弥补了单纯球囊复位的不足。
Objective To investigate the clinical efficacy of percutaneous kyphoplasty (PKP) combined with hyperextension reduction in the treatment of osteoporotic vertebral compression fracture nonunion. Methods Retrospective analysis of 10 cases of osteoporotic vertebral compression fractures treated with PKP combined with hyperextension reduction since 2010-03-2012-03 was performed. The anterior and posterior vertebral height Beck value), Cobb angle and pain visual analog scale (VAS) to evaluate the clinical efficacy. Results The operation time of this group was 20-40 minutes. The volume of injected single vertebral bone cement was 4.5-10 ml with an average of 6.5 ml. All 10 cases were followed up for 6-24 months with an average of 12.6 months. The height of vertebral anterior vertebrae, Cobb angle, Beck value and VAS score at postoperative and final follow-up were significantly improved compared with that before operation (P <0.05), and the indicators at the last follow-up were well maintained. The difference was not statistically significant (P> 0.05). Conclusions Nonunion of osteoporotic vertebral compression fractures has typical clinical and radiological features. The treatment with PKP is satisfactory. Combined with over-stretched position and manual reduction, it can make up for the shortcomings of simple balloon reduction.